Provider Demographics
NPI:1942366968
Name:MAROTTA, JAMES CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHRISTOPHER
Last Name:MAROTTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:895 W JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3229
Mailing Address - Country:US
Mailing Address - Phone:631-982-2022
Mailing Address - Fax:631-982-2024
Practice Address - Street 1:895 W JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3229
Practice Address - Country:US
Practice Address - Phone:631-982-2022
Practice Address - Fax:631-982-2024
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60-2305772082S0099X
NY230577174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2489333OtherUNITED HEATHCARE
NY203164439OtherPHCS
NY1964F1OtherEMPIRE BCBS
NY209980POtherHIP
NY12384513OtherMULITPLAN
NY2146158OtherVYTRA
NY2665516OtherMAGNACARE
NY203164439OtherEMPIRE PLAN
NY5C4214OtherHEALTH NET
NY2931598OtherCIGNA
NY562507OtherFIRST HEALTH
NYAA73131OtherMDNY
NY0109211OtherGHI
NY1113536OtherAETNA HMO
NY7780543OtherAETNA PPO
NYP3674529OtherOXFORD
NY0109211OtherGHI
NY1113536OtherAETNA HMO
NYP00332938Medicare ID - Type UnspecifiedMEDICARE RAILROAD